Please provide all employment information for your past three employers, starting with the most recent.

List two reference names, phone numbers, and years known. (Do not include relatives or employers.)

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize Alodias to investigate my references, work record, education and other matters related to my suitability for employment and, further, I authorize the references I have listed to disclose to Alodias any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosures. In addition, I hereby release Alodias, my former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.

I understand that nothing contained in the application, or conveyed during any interview, which may be granted, or during my employment, if hired, is intended to create an employment contract between Alodia's and me. In addition, I understand and agree that if I am employed, my employment may be suspended or terminated at any time, with or without cause and with or without notice, at the option of either myself or Alodia's, and that no promises or representations contrary to the foregoing are binding on Alodias unless made in writing and signed by me and Alodias Owner.